Moderate alcohol consumption is associated with increased concentrations of adiponectin. Whether this is the case for both total and high–molecular-weight (HMW) adiponectin is uncertain. Furthermore, the rate at which this increase occurs is unclear. Therefore, we examined the effect of moderate alcohol consumption on total and HMW adiponectin. In a randomized, crossover trial, 24 premenopausal women who were regular alcohol consumers received beer (~26 g alcohol) or alcohol-free beer daily for 3 weeks preceded by a 1-week washout. Blood samples were collected weekly after an overnight fast for measurement of total and HMW adiponectin and markers of glucose and lipid metabolism. There was a significant interaction (P <.05) between the 2 treatments over time for both plasma HMW and total adiponectin concentrations. Within 3 weeks, plasma total (8.2%, P = .01) and HMW (8.2%, P = .02) adiponectin levels were higher after moderate alcohol consumption compared with abstention. Changes over time in total adiponectin were positively associated with changes in HMW adiponectin during the nonalcoholic beer (r = 0.80; 95% confidence interval, 0.55-0.92) and beer (r = 0.82; 0.58-0.93) intervention. Alcohol consumption did not affect the ratio of HMW to total adiponectin or the serum glucose, insulin, hemoglobin A1c, or triglyceride levels compared with abstention during the intervention periods. Both total and HMW adiponectin concentrations are higher after moderate alcohol consumption compared with abstention in premenopausal women. These effects were evident after at least 3 weeks of consumption and occurred concomitantly